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Shower Commode

Bathroom

Shower Commode

A shower commode should be selected after assessment of posture, transfers, skin integrity, toileting access, shower access, carer handling, doorway clearance and compatibility with the toilet and shower. Trial the exact configuration in the home.

Overview

A shower commode is a wheeled chair with an open or removable seat that can be:

  • Used for showering
  • Positioned over a toilet
  • Used with a commode pan
  • Moved between the bedroom, bathroom and toilet
  • Used to reduce the number of transfers required

Common types include:

  • Attendant-propelled shower commode
  • Self-propelled shower commode
  • Tilt-in-space shower commode
  • Tilt-and-recline shower commode
  • Bariatric shower commode
  • Folding shower commode
  • Weight-bearing platform shower commode

Purpose

  • Reduce transfers between bed, toilet and shower
  • Support seated showering
  • Support toileting
  • Reduce walking demands
  • Support carer-assisted hygiene
  • Improve safety where wet-area transfers are difficult
  • Support users who cannot safely use a standard shower chair

How to Choose the Type

Attendant-Propelled

Has small castors and is pushed by a carer.

Consider when:

  • The user cannot self-propel
  • A carer is consistently available
  • Space is limited
  • Transfers and hygiene are assisted

Benefits:

  • Smaller turning circle
  • Easier for carers to manoeuvre
  • Often lighter than self-propelled models

Limitations:

  • User remains dependent on a carer
  • Carer must manage brakes, slopes and thresholds
  • Castors may be difficult on uneven flooring

Self-Propelled

Has large rear wheels and handrims.

Consider when:

  • Independent bathroom mobility is a goal
  • Upper-limb strength and coordination are adequate
  • The person can manage wet handrims and brakes
  • Doorways and shower space are wide enough

Benefits:

  • Greater independence
  • Reduced attendant pushing
  • User can reposition independently

Limitations:

  • Wider
  • Heavier
  • Requires more turning space
  • Wet handrims may reduce grip
  • Large wheels can obstruct carer access

Tilt-in-Space

Tilts the whole seating system while maintaining the hip angle.

Consider when:

  • Sitting balance is poor
  • The person fatigues
  • Pressure relief is required
  • Head or trunk support is needed
  • Hygiene tasks require more support
  • The person cannot maintain an upright position

Benefits:

  • Improved postural support
  • May reduce sliding
  • Supports pressure redistribution
  • May improve carer access

Limitations:

  • Larger and heavier
  • Requires more bathroom space
  • More complex controls
  • Higher cost
  • Requires carer training

Tilt and Recline

Adds backrest recline to tilt.

Consider only when:

  • A clear clinical need exists
  • Hip-angle change is required
  • Postural assessment supports recline
  • The user can be safely repositioned

Risks:

  • Increased shear
  • Sliding
  • Entrapment
  • More complex setup
  • Greater space requirement

Weight-Bearing Platform

A platform supports the feet during transfers or sitting.

Consider when:

  • Lower-limb support is required
  • Standard swing-away footrests are insufficient
  • The person needs a stable foot surface

Check:

  • Platform removal for transfers
  • Foot position
  • Heel pressure
  • Clearance over the toilet
  • Carer access

Fitting

Seat Width

Measure hip width and allow appropriate clearance.

Too narrow:

  • Hip pressure
  • Skin damage
  • Difficult hygiene access
  • Restricted transfers

Too wide:

  • Poor lateral support
  • Leaning
  • Difficult armrest access
  • Reduced postural stability

Seat Depth

Check:

  • Thigh support
  • Clearance behind knees
  • Pelvic position
  • Access to hygiene opening
  • Footrest position

Seat Height

Consider:

  • Transfer method
  • Bed height
  • Toilet height
  • Shower floor
  • Foot support
  • Hoist clearance
  • Carer working height

Toilet Clearance

Confirm:

  • Commode clears the toilet pan
  • Seat opening aligns with the toilet
  • Frame does not strike the wall or cistern
  • Castors can be positioned safely
  • Brakes remain accessible
  • The user is centred over the pan

Shower Clearance

Confirm:

  • Doorway width
  • Shower opening
  • Screen clearance
  • Internal turning space
  • Drain location
  • Floor gradient
  • Castor contact
  • Carer space
  • Handheld shower access

Posture and Support

Assess need for:

  • Backrest
  • Headrest
  • Lateral supports
  • Pelvic belt
  • Chest support
  • Calf support
  • Footrests
  • Armrests
  • Pressure-care seat
  • Amputee support

Transfers

Possible methods include:

  • Standing transfer
  • Pivot transfer
  • Slide-board transfer
  • Hoist transfer
  • Assisted lateral transfer

Check:

  • Swing-away arms
  • Removable arms
  • Footrest removal
  • Brake access
  • Seat height
  • Frame stability
  • Carer position

How to Use

Before Transfer

  • Apply all brakes.
  • Move footrests away.
  • Swing or remove armrests as prescribed.
  • Check the seat insert or commode pan.
  • Confirm the chair is stable.
  • Dry the transfer area.

During Use

  • Keep feet supported.
  • Use safety supports as prescribed.
  • Do not move the commode unless the person is positioned safely.
  • Keep hands and clothing clear of wheels.
  • Use a handheld shower hose.

Over the Toilet

  1. Remove the commode pan if using the toilet.
  2. Position the chair centrally over the pan.
  3. Apply all brakes.
  4. Confirm wall and cistern clearance.
  5. Check that the user is aligned.

After Use

  • Remove and empty the pan.
  • Clean and disinfect.
  • Dry the chair.
  • Inspect castors, brakes and upholstery.
  • Store safely.

Risks and Considerations

  • Brake failure
  • Castor movement during transfer
  • Poor toilet alignment
  • Chair does not fit through doorways
  • Insufficient shower space
  • Tipping
  • Sliding
  • Skin injury
  • Foot entrapment
  • Armrest or footrest not locked
  • Carer manual-handling injury
  • Water pooling
  • Corrosion
  • Exceeding safe working load
  • Moving the chair with the person poorly positioned

Do Not

  • Use without applying brakes for transfers
  • Push a self-propelled model by unsupported components
  • Stand on footplates
  • Use damaged castors or brakes
  • Use an incompatible seat
  • Exceed safe working load
  • Move over steps or steep thresholds while occupied
  • Use as a transport wheelchair unless specifically approved

Cleaning and Maintenance

Check:

  • Seat and aperture
  • Pan and lid
  • Frame
  • Castors
  • Brakes
  • Armrests
  • Footrests
  • Upholstery
  • Tilt mechanism
  • Gas struts
  • Corrosion
  • Loose fasteners

Trial Checklist

  • [ ] Correct seat width and depth
  • [ ] Safe working load suitable
  • [ ] Doorways clear
  • [ ] Shower access adequate
  • [ ] Toilet clearance confirmed
  • [ ] Transfer method safe
  • [ ] Brakes accessible
  • [ ] Foot support adequate
  • [ ] Posture supported
  • [ ] Skin risk addressed
  • [ ] Carer can manoeuvre safely
  • [ ] Cleaning plan established

Review Triggers

  • New pressure area
  • Change in posture
  • Change in transfer method
  • Increased assistance
  • Brake or castor fault
  • Weight change
  • Bathroom modification
  • New toilet
  • Repeated sliding
  • Carer concern

Related Notes

References

  • Queensland Health. Mobile Shower Commode Assessment and Prescription Tool: https://www.health.qld.gov.au/__data/assets/pdf_file/0024/423951/msc-assess.pdf
  • Queensland Health. Assessing for and Prescribing Bathing and Toileting Aids: https://www.health.qld.gov.au/__data/assets/pdf_file/0032/1477157/Assessing-for-and-prescribing-bathing-and-toileting-aids.pdf
  • Aidacare. Shower Commodes: https://www.aidacare.com.au/products/bathroom-toilet/shower-commodes
  • Aidacare. Aspire Mobile Shower Commodes Clinical Guide: https://www.aidacare.com.au/globalassets/knowledge/clinical-assistance-guides/aspire-mobile-shower-commodes--clinical-guide.pdf
  • Relevant manufacturer instructions and organisational procedures